How will a life course framework be used to tackle wider social determinants of health?


  • Belinda Nicolau,

    Corresponding author
    1. Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, Canada
    • Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Canada
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  • Wagner Marcenes

    1. Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Belinda Nicolau, Oral Health and Society Research Unit, Faculty of Dentistry, McGill University, 3550 University Street, Montreal, QC, Canada H3A 2A7

Tel.: +15143987203, Ext. 094655

Fax: +15143987220



The life course framework, proposed by Kuh and Schlomo in 1997, offers policy makers the means to understand the interaction between nature and nurture. This conceptual model illustrates how an individual's biological resources are influenced by their genetic endowment, their prenatal and postnatal development and their social and physical environment, both in early life and throughout the life course. Health is conceptualized as a dynamic process connecting biological and social elements that are affected by previous experiences and by present circumstances. Therefore, exposure at different stages of people's lives can either enhance or deplete the individual's health resources. Indeed, life course processes are of many kinds, including parent–child relationships, levels of social deprivation, the acquisition of emotional and behavioural assets in adolescence and the long-term effects of occupational hazards and work stress. The long-term effects of nature and nurture combine to influence disease outcomes. It is only in the last decade that theories, methods and new data have begun to be amalgamated, allowing us to further our understanding of health over the life course in ways that may eventually lead to more effective health policies and better health care. This article discusses life course concepts and how this framework can enlighten our understanding of wider social determinants of health, and provides a few examples of potential interventions to tackle their impact on health.